Cystoscopy with Ureteral Stent Placement
A ureteral stent is placed for obstruction of the ureter. Most oftent the obstruction is from a stones that has passed from the Kidney into the ureter. Scarring, strictures and cancer can also be a cause of ureteral obstruction that would require stent placement
The most common ureteral stent is called a double-J ureteral stent. It is a long thin tube that has a pigtail like coil of either end. The purpose of the coiled ends is to hold the stent in place after it is deployed. Under heavy sedation or general anesthesia the procedure begins with a cystoscopy to inspect the bladder and find the ureteral orifice in the bladder. A guide wire is passed into the ureter and through the obstruction area or next to the obstructing stone within the ureter. Often the assistance of specialized catheters is need to support the wire in its efforts to pass beyond the obstruction. Once the guide wire is passed contrast medium is injected into the ureter to confirm the appropriate position of the wife and the location of the renal pelvis. The double-J stent is passed over the wire and deployed as the wire is removed.
The goals of the ureteral stent is to relieve obstruction of the kidney, allowing urine to flow through the obstruction to the bladder.
Risks Include:
Bleeding: Bleeding is common with the stent in place because of the irrigtation from the stent:
Infection: The stent is a foreign body that attracts bacteria.
Anesthetic Risk: The risk of anesthesia is dependent largely on the patient’s health. The anesthethetic requirement for a stent is usually light
Failure to relieve obstruction: A stent either may not be able to be placed effectively or the obstruction can be too severed to allow for drainage from the kidney after stent placement.
Stent pain or colic: Unfortunately, most patients will feel the ureteral stent. The pain severity can range from mild to severe.
Bladder pain or frequency of urination: The bladder will also feel the stent causing frequency, a, urgency of urination
A ureteral stent is the most common way to relieve obstruction from the kidney. The alternative method to drain the kidney is a percutaneous nephrostomy tube through the back directly into the kidney.
Most ureteral obstruction is considered an urgent or emergent problem. Delaying ureteral stent placement too long can lead to loss of kidney health on the obstructed kidney.
The standard protocol for preoperative anesthesia clearance with your primary physician is important. Many times you will be able to stay on mild blood thinner medication, but that is a case by case basis. The standard limits on eating and drinking prior to anesthesia are in
Most patient will recover within a day or two from the procedure other than the potential ongoing stent related discomfort and expected blood in the urine.